The complete or partial detachment of ligaments, tendons and/or other soft tissues from their associated bones within the body are commonplace injuries, particularly among athletes. Such injuries generally result from excessive stresses being placed on these tissues. By way of example, tissue detachment may occur as the result of an accident such as a fall, over-exertion during a work-related activity, or during the course of an athletic event. In the case of a partial detachment, the injury will frequently heal itself, if given sufficient time and if care is taken not to expose the injury to further undue stress. In the case of complete detachment, however, surgery is often needed to re-attach the soft tissue to its associated bone.
Numerous devices are currently available to re-attach soft tissue to bone. Examples of such devices include screws, staples, suture anchors and tacks. In soft tissue re-attachment procedures utilizing screws, the detached soft tissue is typically moved back into its original position over the bone. Then the screw is screwed through the soft tissue and into the bone, with the shank and head of the screw holding the soft tissue to the bone. Similarly, in soft tissue re-attachment procedures utilizing staples, the detached soft tissue is typically moved back into its original position over the bone. Then the staple is driven through the soft tissue and into the bone, with the legs and bridge of the staple holding the soft tissue to the bone.
In soft tissue re-attachment procedures utilizing suture anchors, an anchor-receiving hole is drilled into the bone, through a drill guide, at the desired point of tissue re-attachment. Next, a suture anchor is deployed through the drill guide and into the hole using an appropriate installation tool. This effectively locks the suture to the bone, with the free ends of the suture and a suture extending out of the bone. The suture can extend through or around the soft tissue, and the suture can be tensioned by pulling the suture to secure the soft tissue to the bone. However, pulling the suture can cause damage to the tissue, such as by causing the suture to partially or fully break through the damaged tissue, which is often referred to as “cheese wiring” through the tissue. The likelihood of causing such damage increases based on factors such as the tissue being compromised prior to the re-attachment procedure, the tissue having a low density, and/or the direction of the pulling force relative to tissue fibers. This tissue damage can greatly disrupt the healing process, and surgical intervention may be needed to reattach the tissue to the bone.
Accordingly, there remains a need for improved methods and devices for securing suture to tissue.